Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 May;39(9-10):658-666.
doi: 10.1089/neu.2021.0351. Epub 2022 Feb 4.

Prognostic Factors for Cervical Spinal Cord Injury without Major Bone Injury in Elderly Patients

Hideaki Nakajima  1 , Noriaki Yokogawa  2 , Takeshi Sasagawa  2   3 , Kei Ando  4 , Naoki Segi  4 , Kota Watanabe  5 , Satoshi Nori  5 , Shuji Watanabe  1 , Kazuya Honjoh  1 , Toru Funayama  6 , Fumihiko Eto  7 , Yoshinori Terashima  8   9 , Ryosuke Hirota  8 , Takeo Furuya  10 , Tomohiro Yamada  11   12 , Gen Inoue  13 , Takashi Kaito  14 , Satoshi Kato  2 ; JASA Study Group
Collaborators, Affiliations
Multicenter Study

Prognostic Factors for Cervical Spinal Cord Injury without Major Bone Injury in Elderly Patients

Hideaki Nakajima et al. J Neurotrauma. 2022 May.

Abstract

In the current aging society, there has been a marked increase in the incidence of cervical spinal cord injury (CSCI) without major bone injury. This multi-center study aimed to identify predictors of neurological improvement in elderly patients with CSCI without major bone injury. The participants were 591 patients aged ≥65 years with CSCI without major bone injury and a minimum follow-up period of three months. Neurologic status was defined using the American Spinal Injury Association (ASIA) impairment scale (AIS). Univariate and multi-variate analyses were performed to identify prognostic factors for walking recovery in AIS A-C cases and full upper extremity motor recovery in AIS D cases. In AIS A-C cases, body mass index (odds ratio (OR): 1.112), magnetic resonance imaging signal change (OR: 0.240), AIS on admission (OR: 3.497), comorbidity of dementia/delirium (OR: 0.365), and post-injury pneumonia (OR: 0.194) were identified as independent prognostic factors for walking recovery. The prevalence of ossification of the posterior longitudinal ligament (OR: 0.494) was also found to be an independent prognostic factor in AIS B and C cases only. In AIS D cases, age (OR: 0.937), upper extremity ASIA motor score on admission (OR: 1.230 [per 5 scores]), and operation (OR: 0.519) were independent prognostic factors for full motor recovery. The severity of AIS at admission was the strongest predictor of functional outcomes. Promoting rehabilitation, however, through measures to reduce cognitive changes, post-injury pneumonia, and unhealthy body weight changes can contribute to greater neurological improvement in AIS A-C cases.

Keywords: cervical spinal cord injury; elderly patients; multi-variate analysis; neurological improvement; no major bone injury; prognostic factor.

PubMed Disclaimer

Conflict of interest statement

No competing financial interests exist.

Figures

FIG 1.
FIG 1.
Flowchart for analyses of American Spinal Injury Association (ASIA) Impairment Scale (AIS) A, B, and C cases and AIS D cases.
See this image and copyright information in PMC

References

    1. Jazayeri, S.B., Beygi, S., Shokraneh, F., Hagen, E.M., and Rahimi-Movaghar, V. (2015). Incidence of traumatic spinal cord injury worldwide: a systematic review. Eur. Spine J. 24, 905–918. - PubMed
    1. Miyakoshi, N., Suda, K., Kudo, D., Sakai, H., Nakagawa, Y., Mikami, Y., Suzuki, S., Tokioka, T., Tokuhiro, A., Takei, H., Katoh, S., and Shimada, Y. (2021). A nationwide survey on the incidence and characteristics of traumatic spinal cord injury in Japan in 2018. Spinal Cord 59, 626–634. - PubMed
    1. Maeda, T., Ueta, T., Mori, E., Yugue, I., Kawano, O., Takao, T., Sakai, H., Okada, S., and Shiba, K. (2012). Soft-tissue damage and segmental instability in adult patients with cervical spinal cord injury without major bone injury. Spine (Phila Pa 1976) 37, E1560–E1566. - PubMed
    1. Sasaki, E., Ono, A., Yokoyama, T., Wada, K., Tanaka, T., Kumagai, G., Iwasaki, H., Takahashi, I., Umeda, T., Nakaji, S., and Ishibashi, Y. (2014). Prevalence and symptom of ossification of posterior longitudinal ligaments in the Japanese general population. J. Orthop. Sci. 19, 405–411. - PubMed
    1. International Standards for Neurological Classifications of Spinal Cord Injury (revised 2019). American Spinal Injury Association: Richmond, VA; 2019. - PMC - PubMed

Publication types